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<p>Allogeneic hematopoietic stem cell transplantation (alloHSCT) is the best consolidative treatment for high-risk acute lymphoblastic leukemia (ALL). The Campus ALL study group analyzed the clinical outcomes of patients treated in the real-life with the pediatric-inspired and minimal/measurable residual disease (MRD)-oriented GIMEMA LAL1913 protocol who underwent alloHSCT. Key factors impacting on outcomes were MRD and remission status (1<sup>st</sup> complete remission vs 2<sup>nd</sup> complete remission) at transplant. MRD positivity was associated with poorer outcomes, with 3-year overall survival (OS) and disease-free survival (DFS) of 47% and 41% in MRD-positive patients compared to 80% and 70% in MRD-negative patients. Additionally, MRD negativity was associated with improved outcomes also&#xa0;for patients in 2nd complete remission with 3-year OS and DFS rates of 60% and 56%, respectively, compared to only&#xa0; 13% for both outcomes in MRD-positive cases. Patients older than 55 years showed survival rates comparable to younger patients, despite having a slightly higher non-relapse mortality, which remained below 20% at 3 years. These findings underscore the crucial role of alloHSCT in high-risk ALL and emphasize the importance of an early accurate disease risk allocation. The adverse outcome observed with MRD positivity advocates for early pre-transplant intervention with immunotherapy, whenever possible.</p>

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Outcomes of allogeneic stem cell transplant in adult Philadelphia negative acute lymphoblastic leukemia patients treated with the pediatric-inspired GIMEMA 1913 protocol. A Campus ALL study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月2日

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  • Gianluca Cavallaro,
  • Davide Lazzarotto,
  • Chiara Pavoni,
  • Francesca Valsecchi,
  • Anna Grassi,
  • Cristina Papayannidis,
  • Marco Cerrano,
  • Nicola Fracchiolla,
  • Fabio Giglio,
  • Michelina Dargenio,
  • Monia Lunghi,
  • Silvia Imbergamo,
  • Maria Ilaria Del Principe,
  • Silvia Trappolini,
  • Monica Fumagalli,
  • Patrizia Zappasodi,
  • Prassede Salutari,
  • Mario Delia,
  • Crescenza Pasciolla,
  • Federico Mosna,
  • Barbara Scappini,
  • Fabio Forghieri,
  • Patrizia Chiusolo,
  • Cristina Skert,
  • Benedetta Cambò,
  • Marzia Defina,
  • Giuseppe Lanzarone,
  • Endri Mauro,
  • Massimiliano Bonifacio,
  • Carla Mazzone,
  • Lidia Santoro,
  • Antonino Mulè,
  • Valentina Mancini,
  • Paola Minetto,
  • Giorgia Battipaglia,
  • Alessandro Cignetti,
  • Lara Aprile,
  • Sabina Chiaretti,
  • Robin Foà,
  • Anna Candoni,
  • Federico Lussana

摘要

Allogeneic hematopoietic stem cell transplantation (alloHSCT) is the best consolidative treatment for high-risk acute lymphoblastic leukemia (ALL). The Campus ALL study group analyzed the clinical outcomes of patients treated in the real-life with the pediatric-inspired and minimal/measurable residual disease (MRD)-oriented GIMEMA LAL1913 protocol who underwent alloHSCT. Key factors impacting on outcomes were MRD and remission status (1st complete remission vs 2nd complete remission) at transplant. MRD positivity was associated with poorer outcomes, with 3-year overall survival (OS) and disease-free survival (DFS) of 47% and 41% in MRD-positive patients compared to 80% and 70% in MRD-negative patients. Additionally, MRD negativity was associated with improved outcomes also for patients in 2nd complete remission with 3-year OS and DFS rates of 60% and 56%, respectively, compared to only  13% for both outcomes in MRD-positive cases. Patients older than 55 years showed survival rates comparable to younger patients, despite having a slightly higher non-relapse mortality, which remained below 20% at 3 years. These findings underscore the crucial role of alloHSCT in high-risk ALL and emphasize the importance of an early accurate disease risk allocation. The adverse outcome observed with MRD positivity advocates for early pre-transplant intervention with immunotherapy, whenever possible.